Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

About the same time last month, I brought your guys some unwelcome news – that physician access to electronic records perhaps doesn’t reduce the number of tests subsequently ordered, and hence doesn’t reduce healthcare costs as much as previously thought.

According to the study:
– It looked at health information exchange and test data between Mass. General Hospital and Brigham and Women’s over a 5 year period from Jan. 1, 1999 to Dec. 31, 2004.
– The study looked at 117,606 patients during this period. Of these, 346 patients had recent off-site tests, of which 44 were done prior to the HIE rollout.
– The study found that for patients with recent off-site tests, there was a 49% reduction in number of tests ordered.
In number terms, the number of tests ordered per person reduced from 7 in 1999 to 4 in 2004.
– There was however a slight increase in number of tests ordered for the population that didn’t have any prior testing done during the same time period – increasing from 5 per person to 6 per person.

These findings directly contradict the Health Affairs study that I mentioned earlier. The Chicago Tribune article has a little researchers-play-nice subsection at the end where the Health Affairs and Partners researchers try to interpret each other’s contradictory results.

If I may add my 0.02:
– Even though the Partners study follows a larger population of patients, the data that is used to calculate the reduction (346 and 44) is way too small
– The Health Affairs studied some 28,000 patients spread across 1,187 doctor’s offices, while the Partners study followed a larger population of patients at two huge Mass. hospitals that entered into a partnership with each other.

While this not directly discounting anything each group has found, I would think the HA study is more representative of what’s going on in different parts of the country, where doctors are using different (in capability/costs) EMRs and labs to get their results. In Partners case there may well be a tacit agreement on EMR brand, or even tacit trust between the labs/facilities that each hospital uses.

Very interesting though, and I’d really love to see what else comes out on EMR and healthcare costs.